ReviewDrugs & aging2018
Non-invasive Management Options for Erectile Dysfunction When a Phosphodiesterase Type 5 Inhibitor Fails.
Review in Drugs & aging, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 35 citations in OpenAlex.
- The 50 most-cited primary studies in penile prosthesis surgery: An all-time bibliometric analysis.International journal of impotence research · 2026Article
- Etiology-oriented rodent models of erectile dysfunction: a narrative review of categorization, modeling strategies, and translational applications.Translational andrology and urology · 2026Review
- Spinal Cord Injury-Related Male Infertility: Oxidative Stress, Inflammation, and Sperm DNA Damage.Journal of clinical medicine · 2026Review
- Utilization of artificial intelligence in Men's Health: Opportunities for innovation and quality improvement.International journal of impotence research · 2026Review
- Using the International Index of Erectile Function-15 in Comparative Analysis Between Transcutaneous Electrical Nerve Stimulation of the Pudendal Nerve and Low-Level Laser Therapy in the Treatment of Erectile Dysfunction After COVID-19.Journal of clinical medicine · 2025Article
- Postoperative complication severity prediction in penile prosthesis implantation: a machine learning-based predictive modeling study.International journal of impotence research · 2025Article
- Fisetin-mediated PPAR-γ upregulation: a novel therapeutic approach for corpus cavernosum smooth-muscle-cell apoptosis and restoration of erectile function after cavernous nerve injury.Translational andrology and urology · 2025Article
- Therapeutic Challenges of Diabetes Mellitus-Related Erectile Dysfunction and The Potential Therapeutic Role of Medicinal Plants: A Narrative Review.Drug design, development and therapy · 2025Review
- Targeting Adenosine A2b Receptor Promotes Penile Rehabilitation of Refractory Erectile Dysfunction.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2024Article
- Predictors of Phosphodiesterase Type 5 Inhibitor Treatment Failure in Patients Diagnosed With Erectile Dysfunction.Cureus · 2023Article
- The Italian Society of Andrology and Sexual Medicine (SIAMS), along with ten other Italian Scientific Societies, guidelines on the diagnosis and management of erectile dysfunction.Journal of endocrinological investigation · 2023Article
- Management of male erectile dysfunction: From the past to the future.Frontiers in endocrinology · 2023Review
- Sexuality, Intimacy, and Reproductive Health after Spinal Cord Injury.Journal of personalized medicine · 2022Review
- Indications and characteristics of penile traction and vacuum erection devices.Nature reviews. Urology · 2022Review
- Restorative Therapies for Erectile Dysfunction: Position Statement From the Sexual Medicine Society of North America (SMSNA).Sexual medicine · 2021Review
- Novel Emerging Therapies for Erectile Dysfunction.The world journal of men's health · 2021Review
- Androgen Deficiency and Phosphodiesterase Type 5 Expression Changes in Aging Male: Therapeutic Implications.Frontiers in endocrinology · 2019Review
- Recent advances in the understanding and management of erectile dysfunction.F1000Research · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Phosphodiesterase type 5 inhibitors (PDE5Is) are the drug of choice for medical management of erectile dysfunction (ED). On-demand PDE5Is have an overall efficacy of 60-70% for ED; 30-35% of patients fail to respond to a PDE5I, and 30-50% of non-responders can be salvaged with detailed counseling on proper use and physician follow-up to ensure that the patient has been prescribed an appropriate and full PDE5I clinical trial. True non-responders may be offered intracavernosal injections of erectogenic drugs, intraurethral alprostadil, or surgical insertion of a penile prosthesis. Such options are not discreet and are associated with more adverse effects than PDE5Is. Thus patients may request additional non-invasive medical management options. This review describes published literature on patients who failed to respond to an on-demand PDE5I regimen and were treated with a non-invasive PDEI-based regimen, including switching from one PDE5I to another; increasing the dose of PDE5I above the labeled dosage range; using two PDE5Is concurrently; using a daily PDE5I regimen; or combining a PDE5I with a testosterone supplement, α-adrenergic antagonist, intraurethral or intracavernosal alprostadil, vacuum erection device, or low-intensity shock wave therapy. The limitations of published clinical trials do not allow for sufficient evidence to recommend one option over another. Therefore, in PDE5I-refractory patients, the choice of a specific next step should be individualized based on the preference of the patient and his sexual partner, the advantages and disadvantages of the various options, the concurrent medical illnesses and medications of the patient, and the patient's response to treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.